Pulmotect, Inc. was founded in 2007 to translate discoveries that induce innate immune resistance in the lung into therapeutics that will provide protection from inhaled pathogens. Our technology platform is a direct result of basic research by our founders on the mechanisms of microbial resistance in the lung epithelium. We have developed an inhaled therapeutic, PUL-042, that provides immediate protection against a broad spectrum of respiratory pathogens. PUL-042 is a clinical stage, specific combination of two well-characterized synthetic molecules, a lipopeptide (Pam2CSK4) and an oligodeoxynucleotide (ODN M362) that act as agonists of the Toll-like Receptors TLR2/6 and TLR9, respectively. This unique, proprietary combination of molecules synergizes to rapidly and powerfully stimulate the body?s natural defenses. The response is localized and specific to the site of administration. In mice, treatment before and after exposure with aerosolized PUL-042 results in increased survival rates to pathogens including multiple Gram+ and Gram? bacteria (three of which are Class A bioterror agents), the fungus Aspergillus fumigatus, and the Sendai and influenza viruses. In each case, increased survival is associated with a reduction of lung pathogen burden, not simply increased tolerance to the pathogen by the host, which indicates a resistance mechanism of action. Pulmotect's long-term strategy is to leverage its technology across a wide array of important threats from inhaled pathogens by limiting the pathogen burden and transmission of disease. The range of applications for PUL-042 currently in development includes use in immunosuppressed patients, pandemic influenza, asthma exacerbations associated with viral infections and manmade bioterror threats as well as naturally emerging viruses. While this broad spectrum technology is not envisioned to replace traditional vaccine approaches, its value and differentiation reside in the ability to confer immediate host-based protection that is not limited by the identity of the pathogen. The potential indications that lie outside the scope of this proposal are synergistic, building on experimental methods that we established since our earliest research in this field. The scientific basis of boosting the innate immune system in the lungs is rapidly expanding as we better understand the underlying mechanism of action. The primary goal of this proposal is to complete a Phase II clinical trial in immunosuppressed cancer patients. This will be a multi-center randomized double-blind trial that will compare PUL-042 against placebo on the overall incidence and severity of pneumonia, specifically on those who have been screened to have a parainfluenza infection prior to enrollment. The three objectives of the trial are described below. ? Primary objective: to determine the safety and tolerability of PUL-042 inhalation solution in patients with documented parainfluenza infection. ? Secondary objective: to determine the efficacy of PUL-042 inhalation solution to prevent the progression of documented parainfluenza infection to clinically documented lower respiratory tract infection. ? Exploratory objectives: 1) evaluate the effect of PUL-042 on parainfluenza viral titers and neutralizing antibodies; 2) evaluate the effect of PUL-042 over time on the microbiome and virome in nasal washes in the study population; and 3) determine whether PUL-042 induces neutralizing antibodies against PUL-042 components. The successful achievement of these objectives will demonstrate proof-of-concept in man and further validate the technology for market use. With secured matching funds already in place, this NIH proposal is designed to help move the project to the end goal, rather than provide the initial seed funds to start the process. The Company would be well positioned to advance existing collaborations, partnerships and discussions with leading large pharma and biotechnology organizations, accelerating the path to the market to address the serious unmet needs that many patients are currently facing.